Search PubMed⌕ Search

Biomedical subjects

D M Berwick

Publications and source records attributed to D M Berwick.

104 records · Page 6Linked to original sources
PubMedDate not supplied

The truth about doctors' handwriting: a prospective study.

OBJECTIVES: To determine whether doctors have worse handwriting than other health professionals. DESIGN: Comparison of handwriting samples collected prospectively in a standardised 10 seconds' task. SETTING: Courses on quality improvement. SUBJECTS: 209 health care professionals attending the courses, including 82 doctors. MAIN OUTCOME MEASURES: Legibility rated on a four-point scale by four raters. RESULTS: The handwriting of doctors was no less legible than that of non-doctors. Significantly lower legibility than average was associated with being an executive and being male. Overall legibility scores were normally distributed, with median legibility equivalent to a rating between "fair" and "good." CONCLUSION: This study fails to support the conventional wisdom that doctors' handwriting is worse than others.' Illegible writing is, however, an important cause of waste and hazard in medical care, but efforts to improve the safety and efficiency of written communication must approach the problem systemically- and assume that the problems are in inherent in average human writing-rather than treating doctors as if they were a special subpopulation.

Female↗
PubMedDate not supplied

Toward an applied technology for quality measurement in health care.

Cost containment, financial incentives to conserve resources, the growth of for-profit hospitals, an aggressive malpractice environment, and demands from purchasers are among the forces today increasing the need for improved methods that measure quality in health care. At the same time, increasingly sophisticated databases and the existence of managed care systems yield new opportunities to observe and correct quality problems. Research on targets of measurement (structure, process, and outcome) and methods of measurement (implicit, explicit, and sentinel methods) has not yet produced managerially useful applied technology for quality measurement in real-world settings. Such an applied technology would have to be cheaper, faster, more flexible, better reported, and more multidimensional than the majority of current research on quality assurance. In developing a new applied technology for the measurement of health care quality, quantitative disciplines have much to offer, such as decision support systems, criteria based on rigorous decision analyses, utility theory, tools for functional status measurement, and advances in operations research.

Decision Support Techniques↗
PubMedDate not supplied

Do physicians have a bias toward action? A classic study revisited.

In an attempt to replicate the findings of a classic study of medical decision making, the authors studied decision making in modern pediatrics practice. They prepared case scenarios and surveyed pediatricians for three common clinical decisions: tympanostomy tube placement, radiography orders, and emergency room referrals. Initial reviewers rated the cases according to the likelihoods that they would take the clinical actions mentioned. Subsequently, other physicians presented with a subset of scenarios in which the initial reviewers were least likely to act tended to be more active in the tympanostomy (p = 0.004) and radiography (p = 0.076) decisions. In these cases the physicians appeared to have a bias toward action. For a subset of scenarios in which the initial reviewers were most likely to act, subsequent reviewers were neither more nor less likely to act than the initial reviewers.

Attitude of Health Personnel↗
PubMedDate not supplied

Seeking systemness.

Explore the source record for details and available documents.

Comprehensive Health Care↗
PubMedDate not supplied

Managing quality: the next five years.

Over the past five years, the principles and tools of quality management have gained a foothold in healthcare, but evaluated in terms of actual breakthroughs in results, the movement has not demonstrated its value as an antidote for America's troubled healthcare delivery system. By reemphasizing their investments in eight critical areas, healthcare leaders can accelerate the pace of improvement and set the stage for fundamental systemic change.

Hospital Administration↗